Heart Failure: Avoiding Medicines That Make Symptoms Worse

Introduction

If you have
heart failure, you need to be extra careful with
medicines. Some can make your heart failure worse. Other medicines may not mix
well with your heart failure drugs.

This Actionset will help you
learn which medicines you may need to avoid and what questions to ask your
doctor or pharmacist.

Each time you see a doctor, make sure he or she
knows that you take medicines for heart failure.

Before you fill
any new prescription, tell the pharmacist that you have heart failure. Ask if
it's okay to take the new prescription medicine.

Before you take
any
over-the-counter medicine, such as a cold or flu
remedy, ask your doctor or a pharmacist if it is safe to take it with your
heart failure medicines.

Tell each doctor about all the other
medicines you take. This includes over-the-counter medicines, such as cold and
flu remedies, herbal products, and natural supplements and vitamins. Take a
list of your medicines or bring your medicines to each doctor's
appointment.

Whether or not some medicines will make your heart
failure worse depends on how severe your heart failure is. It also depends on
what type of heart failure you have.

How do you know if your other medicines are safe to take with your heart failure medicines?

Talk to your doctor or a pharmacist.
Show him or her a list of all the medicines you take.

Be organized

It's important to keep an up-to-date
list of your medicines. Here are some tips:

Make a list of everything you take. Keep a
copy in your purse or wallet, and take it to each doctor or hospital visit.
Anytime you see a new doctor, show him or her your list.

Remember
to include herbs, vitamins, and over-the-counter medicines on your
list.

Have each doctor keep a copy of your list of medicines in
your file.

Make sure your spouse, a family member, your
caregiver, or a friend has an extra copy of your list of
medicines.

Use the same pharmacy or drugstore for all of your
prescriptions.

Update your list if you start a new medicine or
stop taking one.

Ask questions

What if you need to take a medicine
that can make heart failure worse? Here are some things you can do:

Ask your doctor or a pharmacist if it is safe
to take the medicine.

For example, if you have a cold or the
flu, ask which medicine is safe to take.

Ask how long you should
take the medicine and how much you should take. It may be safe to take it for a
short time.

Watch for problems

Call your doctor if you have
symptoms that your heart failure is getting worse, including the following:

You gain weight suddenly, such as
3 lb (1.4 kg) or more in 2 to 3
days.

You have new shortness of breath, a cough, or problems
eating.

Your ankles are more swollen than usual, and you have to
get up more often in the night to urinate.

You need to use more
pillows to sleep at night.

Over-the-counter medicines you may need to avoid

Pain relievers called NSAIDs

Ibuprofen, such as Advil and Motrin

Naproxen, such as Aleve

Aspirin, such as Bayer

If your doctor has told you to take a
low-dose aspirin every day for your heart problems, it's probably okay to take
it. Low-dose aspirin can help prevent blood clots and may prevent a stroke or a
heart attack.

Higher doses of aspirin may make your heart failure
worse. Do not take aspirin for pain, such as from headaches or arthritis. Use
acetaminophen, such as Tylenol, instead.

Cold, cough, flu, or sinus medicines

Be sure to check the label. Do not take
medicines that contain pseudoephedrine, ephedrine, phenylephrine, or
oxymetazoline, such as:

Some antibiotics may interfere with how
your body uses the medicine digoxin. If you take digoxin, talk with your doctor
before taking antibiotics.

References

Citations

Kaul S, et al. (2010). Thiazolidinedione drugs and cardiovascular risks: A science advisory from the American Heart Association and American College of Cardiology Foundation. Circulation, 121(16): 1868–1877.

Kaul S, et al. (2010). Thiazolidinedione drugs and cardiovascular risks: A science advisory from the American Heart Association and American College of Cardiology Foundation. Circulation, 121(16): 1868–1877.

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